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What is known about COVID-19 symptoms and NBA players?

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Not enough.

NBA: Boston Celtics at Portland Trail Blazers Jaime Valdez-USA TODAY Sports

Celtics guard Jaylen Brown had an interesting question for the Twitter-verse: What are the long-term effects of the novel coronavirus?

The short answer is that the data to answer Brown’s question literally and physically do not exist.

The first case of COVID-19 dates to approximately November of last year and the disease did not emerge in the U.S. until January or February. Given the recency of diagnoses, it’s scientifically impossible to explain what the long-term effects of COVID-19. How can researchers document the 12-month recovery status of patients if nobody has been fully recovered for 12 months?

In the interim, the preliminary data do suggest that some people who test positive for COVID-19 will suffer long-term consequences. Lung scarring, increased risk of blood clots, and heart damage have all been documented in recovered patients. The extent to which these symptoms occur and persist in the general population is still largely unknown.

NBA players are young and fit — they’ll be fine, right?

Despite lingering uncertainties around COVID-19, a general narrative has emerged which suggests that even if an NBA player contracts the illness he will be fine since professional basketball players are young and in very good shape. The age and presumed lack of underlying cardiac risk will mitigate any symptoms, or so the theory goes.

That theory, however, is not truly backed by the science. True Hoop interviewed science writer Christie Aschwanden about the topic:

Aschwanden makes the point that the high intensity exercise of a pro sport might actually weaken the immune system and make players more susceptible to the effects of coronavirus — at least one peer-reviewed publication has raised similar concerns, citing a “J Curve” effect of exercise (i.e. moderate exercise is very good for a person, but super intense exercise may have negative effects on immune function).

Aschwanden also notes that NBA players may be more susceptible to the documented effects of COVID-19 than the general population from a professional perspective. She cites case reports of chronic fatigue as an example. Taking her point a step further, for the average person losing a very small amount of lung function would likely have minimal effect on quality of life. It simply doesn’t matter if a weekend warrior runs a 5k in 20:30 instead of 20:00. But a small reduction in lung capacity for an NBA player, where the margins between starter on a playoff team and career D Leaguer are razor thin, could make a massive difference in career success and earnings.

The question of how COVID-19 might affect NBA players is further complicated by the fact that NBA players are, almost by definition, outliers compared to the rest of the population. The mean height of an NBA player is 6’7” — that height is the 99.9624 percentile compared to the male population of the U.S. A possible deleterious connection between height and long-term health is anecdotally feared by NBA players from multiple generations and has been preliminarily documented by one peer-reviewed study.

Specifically in regard to the novel coronavirus, it’s probable that very few people who look like a typical NBA player have been diagnosed with COVID-19 because very few people that tall exist. And a fleetingly small percentage of those people are trained as professional athletes. That makes it impossible to know what kind of effects COVID-19 might have on exceptionally large and fit bodies because very few people in this very specific group have contracted the illness.

Further, some data suggest that NBA players are at high risk for heart disease. The exact cause of this correlation has not been identified — allostatic load due to systemic racism and overtraining have been floated as possible explanations. Regardless of the root cause, it is a concerning trend for NBA players given the link between COVID-19 and other cardiac problems.

They might be fine?

With all of that said, the reality is that it’s still very possible, if not probable, that if an NBA player contracts COVID-19 he will recover without suffering long-term consequences. It’s been documented that multiple players have already tested positive but no reports have emerged of players being forced to sit out the rest of this season. That’s positive anecdotal data. But enough unknowns regarding COVID-19 in general, and in relation to the physiology of NBA players specifically, still exist that it would be foolhardy to declare without doubt that NBA players can risk the illness because they are young and physically fit.